Understanding Long-Term Care Insurance

Author: Debbie Humphrey

Long-term care insurance (LTCI) is an investment people make when offered by their employers, or they purchase a policy on their own, to help cover expenses of long-term care if and when it becomes necessary. Not everyone has it, and those who do, may not understand exactly what it covers.

My friend and Home Helpers® colleague, Jonathan Marsh, did a beautiful job with his 12-part video series that provides clear explanations about multiple facets of LTCI, and I thought it would be beneficial to share some of the most important takeaways, so you have a better understanding of LTCI.

Statistics pertaining to long-term care insurance:

  • 70% of people aged 65 or over will need long-term care.
  • 23.7 hours/week are spent by family caregivers.
  • 1 in 30 Americans own an LTCI policy, which is only 7% of adults over age 50.
  • 70% of LTC cases average 3 years.
  • 73% of LTCI claims start with in-home care.

What is long-term care insurance?

Long-term care insurance helps people live safely and independently when they cannot manage activities of daily living (ADLs) on their own. Policies vary, so it is recommended that you review yours every 2-3 years to get a summary of your current benefits.

There are two types of long-term care:

  • Home-based – Performed by a Home Health Agency for medical/skilled care; or non-medical in-home care services by caregivers who deliver personal care, homemaker services, and companion care.
  • Community-based – Includes care provided in supervised independent living communities, continued care retirement communities (CCRC), assisted living facilities, memory care, and skilled nursing.

What “activities” are considered ADLs?

ADLs include eating, bathing, dressing, toileting, continence, transfers, and cognitive impairment.

Who needs LTC?

That’s hard to answer because every person and their needs are different. There are several factors that may identify someone’s risk of needing LTC:

  • Age – The risk increases as someone gets older.
  • Gender – Women are at higher risk than men because they live longer.
  • Marital Status – Single people are more likely to need LTC from a paid provider.
  • Lifestyle – Lifestyle choices, health, and family history are all risk factors for needing LTC.

Who is eligible to file an LTCI claim?

To be eligible to activate an LTCI claim, one must need substantial assistance with:

  • Performing at least 2 ADLs
  • Protection from threats to health and safety due to cognitive impairment that includes dementia, Alzheimer’s, vascular, Lewy Body, frontotemporal, and mental disability.

As I said, every LTCI policy is different. Some cover only home-based care, while others only cover community-based care. The cost and benefits of your LTCI policy are based on your age when you purchased the policy, the maximum amount the policy will pay, and the optional benefits you choose, such as an inflation rider.

I hope you find this information insightful, and that it helps you understand long-term care insurance a bit better.

I welcome the opportunity to sit down for a FREE consultation and assessment of needs so I can be your advocate in filing LTCI claims for in-home care services. During this assessment, I will answer all of your questions and provide credible resources to guide you through the process of obtaining benefits and getting the care required to stay independent at home or in a community-based setting.

We, at Home Helpers® Clearwater, are honored to have received the Home Care Pulse – Best of Home Care® Provider of Choice Award 2016-2022 and the Best of Home Care® Employer of Choice Award 2022. We proudly serve male and female seniors in Clearwater, Dunedin, Palm Harbor, Safety Harbor, Tarpon Springs, Holiday, New Port Richey, Trinity, Port Richey, Hudson, and surrounding areas. Home Helpers®…we are Making Life Easier℠ 727.942.2539


Jonathan Marsh, Owner Home Helpers® Bradenton



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